Spontaneous dislocation of in-the-bag intraocular lens primarily in cases with prior vitrectomy

PURPOSE. To report cases of late onset spontaneous in-the-bag dislocation of the intraocular lens (IOL) and to compare these results with past reports. METHODS. We retrospectively studied 21 eyes of 18 patients with dislocation of the entire capsular bag containing the IOL. Gender, age, interval between original surgery and IOL dislocation, and the predisposing factors were examined. Cases occurring after trauma were excluded. RESULTS. The mean +/- SD age of the 12 men (57.1%) and 9 women included in the study was 67.8 +/- 8.6 years at the time of the IOL removal procedure. The interval between the original surgery and the IOL dislocation was 7.9 +/- 8.6. Associated clinical conditions included vitrectomy in 8 eyes (40.0%) of 7 patients, high myopia in 3 eyes (14%) of 2 patients, uveitis in 2 eyes (9.5%) of 2 patients, retinitis pigmentosa in 2 eyes (9.5%) of 1 patient, and pseudoexfoliation in 1 eye (4.8%) of 1 patient. There was no identifiable associated condition in 2 eyes (9.5%) of 2 patients, who were comparatively younger than the other cases. This result differs from previously published reports that have found a higher frequency of pseudoexfoliation and lower frequency of prior vitrectomy. CONCLUSIONS. In-the-bag IOL dislocation was frequently associated with prior vitrectomy and sometimes occurred without specific conditions.